Terminally Ill Know What's Best For Them

Opinion - Other Views

As Americans fought over ballots as if they were life and death, the Dutch passed a law a couple of weeks ago that really was about life and death:

Namely, when is it acceptable to end one and welcome the other?

Their answer?

When a patient is suffering. Not necessarily dying. Suffering. Inconsolably. Unbearably.

When that happens, under the new law -- the first of its kind in the world -- any patient older than 16 need only discuss it with a doctor, agree that the pain is too much and ask for a peaceful death.

If the doctor agrees and consults with at least one other physician, then the patient's life can be ended. A lethal dose of barbiturates, putting the patient into a slow coma, eventually stopping the heart and lungs altogether, is the accepted method -- the big word here being "accepted."

Critics say this law will replace caring with killing. Religious leaders see it as sanctioned murder.

"This is like giving the household seal of approval" to euthanasia, lamented Rita Marker, executive director of the International Anti-Euthanasia Task Force. "It's telling people if it's legal, it's right."

Well. I have my doubts about that.

If I've learned anything from exposure to terminally ill and incurably suffering people -- and, sadly, I've had quite a bit of exposure -- it's that they are rarely concerned with legality steering morality. They know what is best for them. When you look death in the face, politics and rhetoric drip away, and you see what is true more clearly than ever.

And the kind of pain that will convince at least two doctors -- and a review board -- that death is the kindest option will likely come from a terminal disease or an extremely rare and horrible one.

We're not talking about a little arthritis here.

What the Dutch are doing is simply decriminalizing something that has been going on for years. And they are doing so under strict guidelines. Before ending a life, a doctor must:

Be convinced the patient's request was voluntary, well-considered and lasting.

Be convinced the patient knows all the alternatives.

Consult with at least one other independent physician.

The doctor also has the right to say no. Even under the new law, assisted suicide is not a right for Dutch patients, just an option.

I asked Rob Jonquiere, the director of the Netherlands Association for Voluntary Euthanasia, when a doctor knows that the time is right.

"It is really up to the patient," he said. "How much suffering is tolerable for one person is different than for another.

"But human beings should have the right to say this is too much."

Now, in the United States, we see it differently. Only Oregon allows doctors to assist in a death, and only if the patient is terminally ill.

Otherwise, America hears this topic and thinks "Dr. Kevorkian." It conjures up images of a scary little man arriving in a van with a killing contraption.

By contrast, the Dutch law actually takes the back alley out of the process and puts death out in the open, with doctors and hospitals.

The people who object are mostly the religious. They think that only God can decide when to take a life. It's hard to argue with that.

It's also hard to argue with someone in such pain that he or she is wailing and crying from sunrise to sunset.

The overwhelming truth is, people don't want to die. Doctors don't want to kill. The request for death as a merciful option is rare and extreme, and when it happens, it is usually in the throes of agony that you and I can't imagine.

The Dutch say let the victims of such pain and the physicians who tend them be the ultimate judges of what is tolerable and what is cruel.

Whether this is playing God or being divinely merciful depends on your upbringing.